Detection and prevalence of HBsAg and HBV DNA among visiting patients attending health facilities in Nigeria

Hyper-endemicity of the Hepatitis B virus (HBV) has for long been retained in parts of Sub-Saharan Africa, including Nigeria with a prevalence rate above 8%. Despite the implementation of vaccination programs, factors such as inadequate diagnostic protocols, the prevalence of occult infections, and population group-specific susceptibility to infection remain overlooked in control strategies. This study, therefore, aims at investigating the prevalence of hepatitis B viral infection, the presence of mutant strains, and establishing a link between age, blood parameters and susceptibility to infection. A total of 451 blood samples from participants aged 1–50 years were tested for the presence of hepatitis B surface antigen (HBsAg) and HBV DNA using rapid diagnostic testing and PCR molecular-based assay. Age, blood group and hemoglobin (Hb) genotype were used to evaluate associated risk of infection. Statistical analysis was done using Python3. A prevalence of 5.8% and 18.2% were recorded using rapid diagnostic testing and PCR molecular-based assay respectively. Correlation between age and, HBV DNA and HBsAg positivity gave a p-value of 1.672. Error rates of 4.4% and 16.9% were recorded for false positives and false negatives respectively, with a rapid test kit sensitivity of 7.32% and specificity of 94.58%. Blood group O rhesus D positive (O⁺) showed a statistically significant higher risk of infection (P < 0.001, odd ratio (OR) = 0.38, 95% CI = 0.23–0.63) compared to non-O blood types. Age groups 21- 30 years and 31–40 years, both showed high relative risk and odd ratios. The low sensitivity found for the available RDT kits negatively influenced the ability to screen for Hepatitis B strains, hence, the high rate of false negatives. The Hb genotype may also play some role or have some association with the viral infection. This study highlights areas to specifically look into in implementing HBV eradication strategies.